Stent fracture after transjugular intrahepatic portosystemic shunt placement using the bare metal stent/stent-graft combination technique

Table 1 Patient characteristics (%)

Characteristics	All		Integrity group		Fracture group		P valuea
	No. patient		No. patient		No. patient
Total	68	100.0	61	89.7	7	10.3
Sex
Male	38	55.9	34	89.5	4	10.5	0.633
Female	30	44.1	27	90.0	3	10.0
Age (yr)
≤ 60	32	47.1	29	90.6	3	9.4	0.567
> 60	36	52.9	32	88.9	4	11.1
Child-Pugh classification
A	22	32.4	18	32.4	4	20.0	0.444
B	34	50.0	32	50.0	2	5.9
C	12	17.6	11	17.6	1	8.3
Stent number
2	55	80.9	51	92.7	4	7.3	0.095
3	11	16.2	9	81.8	2	18.2
4	2	2.9	1	50.0	1	50.0
Reoperation
No	59	86.8	54	91.5	5	8.5	0.230
Yes	9	13.2	7	77.8	2	22.2
Gradient
Portosystemic gradient (median, IQR)			15.0 mmH2O (12.0-16.0)		14.0 mmH2O (13.5-15.0)		0.745
Stent angle
Angle 1 (median, IQR)			1.0 (0-22.0)		20.0 (3.5-35.0)		0.151
Angle 2 (median, IQR)			15.5 (0-33.8)		39.5 (30.5-60.5)		0.009

^aDifferences between the stent integrity group and the stent fracture group were analyzed using the Fisher’s exact test for categorical variables and the Mann-Whitney U test for continuous variables.

IQR: Interquartile range.

Table 2 Characteristics and clinical outcomes of patients with stent fracture after transjugular intrahepatic portosystemic shunt placement

Case	Age (yr)	Sex	Child-Pugh classification	Number of procedures	Fracture time (days after procedure)	Fracture type	Symptoms	Clinical outcome
1	60	Male	B	1	159	IIIb	None	Re-operation to implant a bare metal stent to connect the fractured stent
2	63	Female	A	1	512	I	Bleeding recurrence CT revealed shunt stenosis	Endoscopic hemostasis
3	49	Male	C	2	675	I	Bleeding recurrence CT revealed shunt stenosis	Re-operation using a bare metal stent to reconstruct the shunt
4	70	Female	A	1	175	I	None	Observation
5	79	Female	B	1	141	IIIa	None CT revealed shunt stenosis	Observation
6	51	Male	A	1	1752	I	None CT revealed shunt stenosis	Observation
7	62	Male	A	2	1406	II	None	Observation

CT: Computed tomography.

Table 3 Multivariable logistic regression of the risk factors for stent fracture

Characteristic	Adjusted odds ratioa	P value	95%CI
Stent number	22.2	0.038	1.2-415.4
Reoperation
No	Reference
Yes	0.3	0.562	0.0-13.8
Stent Angle
Angle 1	0.9	0.191	0.8-1.3
Angle 2b	1.1	0.020	1.0-1.3

^aModels were adjusted for covariates with clinical relevance (i.e., stent number, reoperation and Angle 1) and those found to be significant in univariate analyses (i.e., Angle 2).

^bBending angle of the axis of the end segment and the mid-segment of the stent in the sagittal plane.

CI: Confidence interval.